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Posterior Lumbar Fusion

post #1 of 14
Thread Starter 

I am 45 yr male, 5' 5", 170lbs. I have a grade 2 spondylo @ L5 w/3 disc herniations from L3 down. The 2012-13 season does not look good.By first trying some RFA (radiofrequency nerve ablation) procedures I may get some short term releif from the leg pain with hopefully getting some muscle control back in my right leg. I'm hope this enables me to salvage a portion of the season because my kids are really bumbed about this because we all purchased new gear this year, and have a multi family trip for presidents week booked and paid for.  Before Labor day I was in pretty good shape and ready to ski hard, since then my physical condition has deteriorated fast,  and due to the inactivity I have gained 10 lbs. 

 

Is anyone skiing, or have any experience with a condition/injury like this ?

will I ever be able to ski again if the fusion is my only option ?

 

Thanks for any input....

post #2 of 14

So sorry you are going through this. Obviously can't give medical advice in a forum, but can share experience...

 

My husband had a partial laminectomy at that general area and a cervical fusion and he is skiing again. You are young which bodes well. Physical Therapy, yoga and Celebrex (and the occasional epidural injection) are what my husband uses to get through.

 

Try everything you can before surgery. Get second and third opinions.

 

You will ski again.  I also know someone in his late 80's whose had several fusion surgeries and even several spontaneous fusions and he still skis!

 

Good luck.

post #3 of 14
Thread Starter 

Thanks for the reply Mom, that is pretty much what my mom has been telling me......lol...although my folks have'nt skied in decades. It sseems skiing has changed alot within the last 10 or 15 years. My condition has got alot worse, I will settle for just being able to put my gear on. hope you have a great season, thanks again.

post #4 of 14

remember that 70% of your spinal mobility comes from your thoracic spine

post #5 of 14
Thread Starter 
Quote:
Originally Posted by loboskis View Post

remember that 70% of your spinal mobility comes from your thoracic spine

I'm not sure I understand how my thorasic spine affects my lumbar. Are you talking about posture/stance? Or upper body physical condition?

post #6 of 14
Quote:
Originally Posted by vwr1vwf View Post

I'm not sure I understand how my thorasic spine affects my lumbar. Are you talking about posture/stance? Or upper body physical condition?

 

I think what loboskis meant is that 70% of spinal mobility should come from your thoracic spine.

 

The reason this is relevant is that, often low back problems are either the result of, or exacerbated by, poor thoracic spine and/or hip mobility. The theory goes that the anatomy of the lumbar vertebrae are such that there really isn't much room for movement (rotation, flexion and extension). but as you move into the thoracic spine, the alignment of the facet joints is such that there is room for quite a bit of movement. 

 

Similarly, the hip is a ball and socket joint, meaning lots of room for movement. 

 

So how is this relevant to your issues in the L vertebrae? If you have reduced mobility in the thoracic spine and/or the hips - which most people who have desk jobs do, as do most cyclists and many skiers (the postures are similar) - then when you move in a way that requires any flexion, extension or rotation, your lumbar region ends up having to move more than it was meant to.  This becomes "the perfect storm" for low back problems if this is accompanied by weak core muscles. 

 

Often people's low back problems improve if they improve their t-spine and hip mobility and also improve core strength. This is not to say that it will repair the existing damage, but rather it helps the body to move as it should so that your daily living doesn't continue to put extra pressure and strain on the damage. For many people, this can be enough (or in conjunction with physio/manual therapy) to make them completely symptom free.  

 

I've written a few articles about what I've learned regarding low back pain here:

This summarizes what I've learned about low back stuff and the exercises I typically use with low back pain clients (I get lots of referrals from manual therapists):

http://elsbethvaino.com/2011/05/6-exercises-for-low-back-health/ 

This one's a summary of what I learned at a seminar I attended by a world-renowned physical therapist about the hip and spine:

http://elsbethvaino.com/2010/12/lessons-of-the-hip-and-spine-from-dr-shirley-sahrmann/ 

And a two-part summary of what I learned at a seminar I attended by a world-renowned spinal biomechanist:

http://elsbethvaino.com/2009/11/lessons-about-low-back-pain-part-one/

http://elsbethvaino.com/2009/11/low-back-pain-redux/

 

Elsbeth

post #7 of 14
Thread Starter 
Quote:
Originally Posted by evaino View Post

 

I think what loboskis meant is that 70% of spinal mobility should come from your thoracic spine.

 

The reason this is relevant is that, often low back problems are either the result of, or exacerbated by, poor thoracic spine and/or hip mobility. The theory goes that the anatomy of the lumbar vertebrae are such that there really isn't much room for movement (rotation, flexion and extension). but as you move into the thoracic spine, the alignment of the facet joints is such that there is room for quite a bit of movement. 

 

Similarly, the hip is a ball and socket joint, meaning lots of room for movement. 

 

So how is this relevant to your issues in the L vertebrae? If you have reduced mobility in the thoracic spine and/or the hips - which most people who have desk jobs do, as do most cyclists and many skiers (the postures are similar) - then when you move in a way that requires any flexion, extension or rotation, your lumbar region ends up having to move more than it was meant to.  This becomes "the perfect storm" for low back problems if this is accompanied by weak core muscles. 

 

Often people's low back problems improve if they improve their t-spine and hip mobility and also improve core strength. This is not to say that it will repair the existing damage, but rather it helps the body to move as it should so that your daily living doesn't continue to put extra pressure and strain on the damage. For many people, this can be enough (or in conjunction with physio/manual therapy) to make them completely symptom free.  

 

I've written a few articles about what I've learned regarding low back pain here:

This summarizes what I've learned about low back stuff and the exercises I typically use with low back pain clients (I get lots of referrals from manual therapists):

http://elsbethvaino.com/2011/05/6-exercises-for-low-back-health/ 

This one's a summary of what I learned at a seminar I attended by a world-renowned physical therapist about the hip and spine:

http://elsbethvaino.com/2010/12/lessons-of-the-hip-and-spine-from-dr-shirley-sahrmann/ 

And a two-part summary of what I learned at a seminar I attended by a world-renowned spinal biomechanist:

http://elsbethvaino.com/2009/11/lessons-about-low-back-pain-part-one/

http://elsbethvaino.com/2009/11/low-back-pain-redux/

 

Elsbeth

wow, thanks for putting that in perspective for me and inspiring some hope. I really appreciate this.

post #8 of 14

Thank you ,Elsbeth

Thats exactly where I was thinking.

Here is a little example of what the T-spine is capable of

post #9 of 14
Quote:
Originally Posted by loboskis View Post

Thank you ,Elsbeth

Thats exactly where I was thinking.

Here is a little example of what the T-spine is capable of

 

I would actually call that an example of excessive lumbar mobility, and a prime example of why dancers and gymnasts tend to have horrible low back problems later in life. Dr. McGill (I mentioned him above) noted in either his book or presentation that something like 95%+ competitive gymnasts end up with facet joint stress fractures, and it's from doing things like you see in this video. 

 

Cricket bowlers are the other athletes who tend to have a very, very high rate of facet joint problems.

 

Not good!

 

Elsbeth

post #10 of 14
Quote:
Originally Posted by evaino View Post

 

I would actually call that an example of excessive lumbar mobility, and a prime example of why dancers and gymnasts tend to have horrible low back problems later in life. Dr. McGill (I mentioned him above) noted in either his book or presentation that something like 95%+ competitive gymnasts end up with facet joint stress fractures, and it's from doing things like you see in this video. 

 

Cricket bowlers are the other athletes who tend to have a very, very high rate of facet joint problems.

 

Not good!

 

Elsbeth

Excessive is probably an understatement

post #11 of 14

 I have L4/L5 disc "challenges" and have had a coocyx amputation, I ski with a TENS machine which helps me out no end. My original unit was tried out for a month under medical supervision to make sure I understood it, I then bought one quite cheaply over the internet with a referral prescription from the Doc.

 Might be an avenue worth asking about when you next see your surgeon/physiotherapist/pain clinic. If you want to PM me for any more details feel free to do so.

post #12 of 14
Thread Starter 

Thanks for the reply Lilywhite, I apologize for taking so long to respond, I just checked back here today and discovered your reply. I have a Tens unit and unfortunately it does not help with the leg pain, but it is very affective on the low back pain which has pretty much been gone for a few months now.

 

I have had 3 nerve blocks which have lasted on average about 3 weeks each, that enabled me to get about 15 half days in and I plan on trying to get 1 more day since we have such a healthy snow pack this spring here in Northern NY. They controlled the pain but unfortunately did not help with the numbness so I had some problems with control in trees and bumps making right turns.

 

So all in all under the circumstances I consider myself lucky to have skied as much as I did, and our annual family and friend ski trip was possible. The bad news is I am out of options and at the end of the road with this.  After escaping the fusion for 17 years I have thrown in the proverbial towel, next month I am having a 3 level Posterior Lumbar Interbody Fusion from L3 to S1. We shall see about next season. I am determind to ski next year.

 

Thank you all for the advice.

 

Rich C.

post #13 of 14

http://www.stopchasingpain.com/

This guy is in Northern NJ

It would be well worth your while to see him before you let them cut you.

He does some amazing things

post #14 of 14
Thread Starter 
Quote:
Originally Posted by loboskis View Post

http://www.stopchasingpain.com/

This guy is in Northern NJ

It would be well worth your while to see him before you let them cut you.

He does some amazing

I appreciate the advice, and may take you up on seeking some additional pain managment post op. I guess the grade II spondylo has slipped to a grade III and needs to be stabilized.

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